How Shoe Inserts (Orthotics) Can Help After Total Knee Replacement

(I may earn a small commission from the products mentioned in this post.)

One of the most underrated things to consider after knee replacement surgery is your feet. Our feet absorb the daily pressure of carrying our body and they’re in constant contact with the Earth’s surface.

If it weren’t for gravity our joints would likely last much longer, but this isn’t the case. We walk, run, and jump during exercise because it’s good for our body and our heart. Over time the miles add up and our joints wear down.

The wear and tear can occur faster if you’re overweight – this puts more pressure on your knees and joints.

In this article we’ll discuss how taking extra care of your feet after knee replacement surgery can help you recover quickly and add cushion to your step. Using shoe inserts or orthotics can be a minor action that pays big dividends.

Finding A Great Pair Of Shoes After Knee Replacement Surgery

In another knee replacement recovery article we mentioned how choosing the right shoe can help reduce knee pain. I’ve worn a lot of shoes in my life and I have a few preferred brands that I use for different activities.

If I’m out for a walk or hiking I’ll usually have on Hoka Bondi 7. If I’m at the beach, I’ll have my favorite soft-soled sandals.

Should you buy new shoes after surgery? Yes, you should probably get new shoes after knee replacement, especially if you wear flat shoes or sandals that don’t offer much support.

Most people keep shoes much longer than they should and even longer if they were an expensive investment. The padding and shock-absorbing ability in shoes break down over time.

Runners, hikers, and walkers should be replacing their shoes every couple months to keep their feet, knees, and hips healthy. If you’re having TKR surgery it’s a wise move to purchase new shoes for your new knee(s).

RelatedBest Shoes for After Knee Replacement Surgery

What Are Orthotics And How Can They Help Me After Knee Replacement

According to WebMD, orthotics are molded shoe pieces that are made from any material (leather, rubber, metal, plastic) and fit into a shoe.

Orthotics can provide a number of benefits including:

  • Padding
  • Repositioning of the foot/ankle (pronation or supination)
  • Tilting the foot forward or back
  • Arch support
  • Reduce pain caused by problems such as plantar fasciitis

Orthotics can be custom-made by a doctor or specialist and they can also be purchased in generic molds at local pharmacy and grocery stores.

If you’ve had foot problems in the past you might have used shoe inserts. People with flat feet, high arches, or more general foot pain will want to speak to their doctor after TKR to find a suitable insert for your particular needs.

If you haven’t had foot problems in the past, a cushion can provide some added protection for your new knee – we’ll talk about that next.

Related: Best Ice Pack for After Knee Replacement

How Do Orthotics Work For Knee Pain

Most people recovering from total knee replacement surgery won’t require custom orthotics. An extra layer of padding and support may be all that’s needed. In fact, there are only a few differences between custom orthotics and prefabricated shoe inserts.

The main difference is that custom orthotics are molded to your foot and might be slightly stronger. According to Anthony C Redmond in the Journal of Foot and Ankle Research, customized and prefabricated orthoses helped reduce pressure-time and force-time in the forefoot. The research did not find significant differences between customized and prefabricated shoe inserts (source).

In other words, both types of inserts displayed an ability to reduce pressure on the foot but custom versus store-bought shoe inserts showed little difference in their shock absorbing qualities.

In 2 additional studies, researchers found that there was little difference between custom orthotics and inserts available at stores. Both of these studies were not for knee pain, however I highlight them (study 2) because many studies show how shoe inserts are effective for various leg problems, yet they find little difference between the widely available and inexpensive shoe inserts (like Dr. Scholls) and more costly options such as custom orthotics.

For the reasons above, I suggest 1st trying one of the many prefabricated shoe inserts available. They come in all shapes and sizes:

  • Gel inserts
  • Silicone
  • Leather
  • Whole foot
  • Heel
  • Arch support

I chose to focus on the heel of the foot because my heel lands on the pavement first. I also used heel cups before my surgery and had a few pairs for my shoes that I wear around the house and for exercise.

They slip into the heel easily and because of the texture, they don’t slide.

Another option is a whole foot pad. Maybe a whole foot gel or foam pad is best for you if you tend to land on the middle or front of the foot while walking – it’s really a personal preference. We like these options below.

The Best Shoe Insoles After TKR

HLYOON Sports Gel Insoles (Men and Women)

These are great for adding padding in your shoe. It uses a gel-like substance and polyurethane with viscoelastic memory foam so the pad conforms to your foot.

It comes in a few broad sizes that you will cut down to match the insert of your shoe. Once you cut it to size, slide it in and the non-slip bottom will hold firm against the bottom of your shoe.

>>check Hyloon Insole price and reviews on Amazon

These are marketed for active people who need more cushion – sounds perfect for people recovering from knee replacement surgery. Many reviewers comment that they were recommended custom inserts and these have performed better – I’m not surprised.

These are stylish (although it doesn’t matter because you won’t see them) and they are thick. Some people mention too thick but if padding is what you want, then they should be thick right?

Related: Best Walking or Hiking Poles After Knee Replacement

Powerstep Pinnacle Plus Orthotic Shoe Inserts

Powerstep is a well-reviewed item and made in the U.S.A. It uses a dual layer cushion made from EVA foam which provides long-lasting comfort.

The top fabric is anti-microbial and won’t slip in your shoe. Unlike other full-length shoe inserts, these don’t have to be trimmed.

Simply select your shoe size and slip them in (more convenient). These inserts also have adequate arch support if that’s what you need.

In the reviews, there are actual podiatrists who recommend the inserts. This particular person states that patients should try these over-the-counter options before investing in custom orthotics – that’s reassuring for those of us who have considered paying more for custom shoes and inserts.

>>check Powerstep price and reviews on Amazon

Other comments are mostly positive and customers say that they are great but don’t last forever. After a year or so you might want to try another pair. Support U.S. companies and buy from them.

Armstrong Amerika – Gel Heel Cup Inserts

I think these are the most stylish heel pads and they come in a 3 pack to fit in 3 pairs of your shoes – don’t worry about taking 1 pair out and inserting to other shoes. For 3 pair the insoles come at a great price.

I like the fact they’re made from silicone. I’ve used heel cups before and they changed the way my legs feel when walking and running. In my opinion, it feels much better.

If you plan on walking a lot in the months following TKR surgery, consider adding these to your favorite hiking or walking shoes. Every little bit of cushion helps to reduce the impact on your new knee. The benefits might help your hips too!

>>check Armstrong Amerika price and reviews on Amazon

They come in 2 sizes (small/med and large). Don’t worry too much about the size because they should fit snuggly into the heel.

Customers mention how they went from walking on injured heels to walking on clouds. Other people use them in their boot and for jobs where they stand a lot. With a few hundred solid reviews I like what Armstrong Amerika has to offer.

Tuli’s Classic Heel Cups with Lifetime Warranty

I’ve used these before and they work great. Seeing them brought back memories of my old basketball days – I wore Tuli’s the whole season and they gave me some relief.

Tuli’s are a classic American company that sells heel cups. They are under the umbrella company of DJO Global based in Vista, California – the same company that makes the Aircast Cryo Cuff.

>>check Tuli’s price and reviews on Amazon

This product is made in the U.S. and they have a lifetime warranty. That’s hard to beat. If you want to add a simple cushion to your step and protect your knee replacement, consider Tuli’s heel cups.

Frequently Asked Questions with Feet, Shoe Inserts (orthotics) and Knee Replacement

Can I Have Foot Problems After Knee Replacement

If you didn’t have foot problems before knee replacement, it’s unlikely you’ll experience foot problems after. Obviously surgery affects each patient in different ways.

It’s possible there are alignment issues with your new knee and it puts more pressure on your foot. This could result in foot pain as your body adjusts to the new knee. If you’re overweight, you might experience more foot pain than you would otherwise because your feet must carry the weight.

One thing you should definitely prepare for is some swelling in your leg after knee replacement surgery. It’s natural for the leg to experience swelling and that’s why I often discuss being diligent with RICE (Rest, Ice, Compression, and Elevation).

After surgery, it’s important to know how much exercise is enough so you don’t overdo it.

Using shoes that provide a cushion and adding a shoe insert for extra shock absorption could aid your recovery like it did mine.

Will Shoe Inserts Cause Back Pain

Similar to the above question, you might experience some back pain after TKR surgery. In order to reduce the chance of back, knee, and foot pain, it is imperative you prepare for surgery well in advance.

Exercise, flexibility, and strength should be the focus of your TKR surgery preparation. After surgery, there won’t be time to “relax” as you’ll work with physical therapists to rehabilitate your knee and body.

There’s a chance you might experience back pain after surgery because your body’s alignment has changed. Consider this: If you’ve been limping for the past 10 years, the structure of your body and its muscles have also changed. After TKR surgery you might not have a limp (if all goes smoothly).

As a result, you stand taller and engage muscles that before over compensated for your knee pain. As your body adjusts it’s reasonable to expect some back pain – just make sure you focus on recovery, strength, and flexibility and share how you feel with your doctor.

Shoe inserts will have a subtle impact on posture and alignment. If you feel pain from the inserts you should remove them. If you feel benefit from the inserts, continue using them.

Related: Must Have Items for Knee Replacement

How Long Do Shoe Inserts (orthotics) Last

Similar to a good pair of shoes, orthotics won’t last forever. I mentioned above that shoes worn for exercise should be replaced every 3-6 months depending on your activity level. Shoes will account for more of your shock absorption so their importance is greater than orthotics.

If you’re wearing orthotics every day, they will wear down after a few months. It also depends on the material of your shoe inserts – silicone and rubber will last longer and have less need to be replaced. Foam inserts should be replaced more frequently because the material can become compacted over time.


In this article we discussed how orthotics can help after knee replacement surgery. We walk on our feet every day so we should care about the shoes we wear.

Shoe choice is actually more important when recovering from knee replacement surgery. You can also use shoe inserts, or orthotics, to help reduce wear and tear on your new knee.

Recovering from TKR surgery won’t be easy. That’s why the little things, like heel cups, can make a big difference in how your knee feels and responds. Research has shown that custom orthotics and over-the-counter shoe inserts can benefit our feet.

But custom orthotics aren’t necessarily better than prefabricated inserts available at your local store. Before investing in custom orthotics, it’s wise to try out Dr. Scholls or another well-respected brand.

The extra cushion in your new shoes might be the perfect recipe to recover quickly. In my recovery, I’ve used shoes with ample padding and I added the extra cushion from inserts. We hope this article provides valuable information for you and your knee replacement recovery. Thanks for reading!

2 thoughts on “How Shoe Inserts (Orthotics) Can Help After Total Knee Replacement”

  1. So more confused than before. 2016 TKR, 11/2018 TKRevision same knee. Extreme bowing now. With shin splints on weight bearing. Do I need orthotic or heel cups?
    Kathy J Lewis,

    • Hi Kathy, thanks for the message. I’m sorry to hear you needed a revision and are experiencing shin splints. For your individual situation, you’ll want to consult with your doctor – they know best. I can only provide the general info I shared in the article. Best wishes.

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